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General NPI Number Information
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NPI Number | 1366823197
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Entity Type | Organization
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Legal Business Name | ROYAL TREATMENT MENTAL HEALTH SYSTEMS, LLC
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Dates
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Enumeration Date | 06/17/2015
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Last Update Date | 06/17/2015
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Provider Practice Location Address
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Address Line | 5555 CORNER AVENUE
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City | DETROIT
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State | MI
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Zip | 48213
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Country | US
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Telephone | 313-624-7966
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Fax | 313-447-3999
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Provider Business Mailing Address
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Address Line | 535 GRISWOLD ST STE 111
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City | DETROIT
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State | MI
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Zip | 48226-3673
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Country | US
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Telephone | 313-624-7966
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Fax | 313-447-3999
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Authorized Official
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Title or Position | CEO
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Name | MR. GARKYE HART
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Credential |
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Telephone | 313-624-7966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | D9312H
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License Number State | MI
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